Paramedics care for a patient in West Palm Beach. Credit: Joe Raedle/Getty Images

Tampa paramedic Steve LaDue was attending a funeral for a fellow first responder when another colleague collapsed with a heart attack. As he was trained to do, LaDue rushed to treat the man, but failed to save his life.

It was the last straw for a career dedicated to other people’s traumas.

“My brother really struggled to come back from it. He actually couldn’t go on calls. Every time a call came in, he struggled to get in the truck,” LaDue sister, Megan Vila, recalled recently.

LaDue began drinking to excess and getting into arguments with his wife. “All the signs and symptoms of many first responders who are struggling with post-traumatic stress,” Vila said.

He read the Bible obsessively – and relived traumatic calls he’d responded to. “He went on a downward cycle and ultimately he ended his own life. He shot himself in September 2018. My brother is no longer with us,” Vila said.

“Unfortunately, he’s not alone.”

Florida’s leaders are now addressing an epidemic of suicide and post-traumatic stress among the state’s law enforcement officers, firefighters, and emergency medical responders.

Legislation approved in 2018 – over initial opposition from the Florida League of Cities, which employs most of Florida’s first responders – extended workers’ compensation coverage to people like LaDue, whose own claim had been denied because he’d suffered no physical, only psychic, injury. Jimmy Patronis, the state’s chief financial officer and fire marshal, had pushed the legislation.

And First Lady Casey DeSantis, who’s been holding “listening sessions” across the state about mental health, invited a range of first responders to the Governor’s Mansion on Dec. 10 to discuss approaches to the problem among first responders. Villa, who’d lobbied for the workers’ comp bill in her brother’s memory, attended.

“You have some of the bravest people in society who day in and day out are going out and putting themselves in harm’s way. Then they’re going home and having to internalize this,” DeSantis said during a news conference outside the mansion.

“We want them to know that it’s OK to not be OK. That if they need to seek help, we need to let them know there are resources out there.”

Deaths among first responders by suicide have exceeded those in the line of duty for four years running, Florida Department of Law Enforcement Commissioner Rick Swearingen said.

State officials estimate that 30 percent of first responders have considered or attempted suicide or suffer from post-traumatic stress or substance abuse. Suicidal ideation among fire fighters and paramedics runs 10 times the rate for the general adult population. Suicide attempts run six times higher.

At the root of the problem is stress that accumulates over time. Most people will experience five traumas during their lives, said Dustin Hawkins, who serves with Indian River County Fire and Rescue and as co-chairman for the Florida Fire Chiefs’ Association’s mental wellness subcommittee.

First responders might spend 30-year careers exposed to trauma – “hundreds and thousands of life-altering moments where they went and approached and sustained a moral injury,” he continued. “We know what death looks like, sounds like, tastes like, and smells like.”

“The horrible things that people see, they live with them. When you go home to your family, you can’t just leave it at the door,” Pasco County Sheriff Chris Nocco said.

“You think about the things they see day in and day out,” Vila said.

“Children dying in their arms, murders, suicides, horrible vehicular accidents. Police officers being shot at. Mass shootings in schools. They witness these things and then they have to bear all of that inside of them and then go home to their families and take care of the responsibilities they have day in and day out. How do you do that? How to you separate yourself from that?” she said.

The public suffers, too.

“When you say a deputy was rude and discourteous, we have to bring them in,” Nocco said. “Your moment with them may have not been the best. But you did not know they just saw the worst things in society and now they’re trying to be normal and nice, but they’re still struggling with that.”

Even absent trauma, the job subjects families to stress, Villa said. Her own first-responder husband works 24-hour shifts. “The kids don’t see him. I don’t see him.”

Jurisdictions are beginning to offer support to first responders and their families. Pasco County, for example, offers a program that “allows us the opportunity to have a family that understands what we’re going through, and better recognize the trauma cycle, so we can communicate and connect,” Hawkins said.

He’d like to see the program expanded statewide.

Another solution is mandatory training about what experiences and symptoms first responders should expect, and ways to cope. State law now requires that Florida’s more than 70,000 certified firefighters must undergo such training, said Julius Halas, director of the Division of State Fire Marshal.

“It has to start at the base level, when these young men and women are starting out in their careers, when they’re going to school and they’re being taught their profession. The mental component needs to be in place as part of the curriculum,” Vila said.

“My husband’s been on the job for 23 years with Tampa Fire and Rescue. Every year he has to get a physical. He has not one time had to have a mental evaluation since he was hired. That needs to be implemented as well. When you make it mandatory for everyone, then you’re not singling someone out.”

Villa’s own husband responded only recently to a flaming wreck from which the rescue team was unable to extract screaming victims, she said.

“Who has to get that burned body out of the car? My husband does. And then he has to come home to me and six kids yelling and screaming. How do you separate yourself from that? The way that do that is, you kind of turn your emotions off. You become stoic, and you do lose that emotional connection. Not done on purpose, but it’s their way to survive.

“That’s why the support needs to get behind these first responders. We need to be able to talk about it. It’s not mandatory, when they go on these critical incidents, that they talk about it. If you make it mandatory, all of you get together and you talk about it, then it’s not singling out one person and you can feel safe that you’re not going to have your job in jeopardy.”

Vila sees real progress being made.

“The fact that I’m standing here at the Governor’s Mansion two years after my brother’s death – I know that he’s looking down and he’s very proud of the men and women of the state of Florida that people can come forward,” she said.

“It’s not going to be easy. It’s going take that first responder taking that first step, not being in fear of losing their job, not being in fear that they’re going to be judged or think oh, you can’t handle your job anymore. You can, and we’ve got to streamline ways for them to get help and get them back to work.”

Michael Moline has covered politics and the legal system for more than 30 years. He is a former managing editor of the San Francisco Daily Journal and former assistant managing editor of The National Law Journal. He began his career covering the Florida Capitol for United Press International. More recently, he wrote for Florida Politics.